Federal State Budgetary Educational

The pancreas is a parenchymal organ located retroperitoneally. Performs two main functions exocrine and endocrine. Violation of these functions, as well as inflammatory and destructive processes in the pancreas define

clinical picture pancreatic diseases.

1) painful (in the epigastrium, shingles, after taking

alcohol, fatty and spicy foods).

2)dyspeptic (weight loss, vomiting that does not bring relief, abundant loose stools with pieces of undigested food)

3)asthenovegetative (decreased

performance, rapid fatigability, weakness, irritability, increased fatigue), low blood pressure

- signs of diabetes mellitus: weakness, sweating due to the development of hypoglycemia.

5)cytolysis (with pancreatitis, increased entry into the blood of pancreatic enzymes so-called evasion

enzymes) amylase, lipase, trypsin in the blood,

diastases in urine

6)exocrine insufficiency – concentration of bicarbonate and enzymes in the duodenal contents, the presence of undigested muscle fibers (creatorrhea), neutral fats (steatorrhea), starch (amilorrhea).

abdomen in a patient with CP:

1. Desjardins point - 5-7 cm from the navel, along the line, connecting the navel to the right axillary cavity (head of the pancreas)

2.Shofar zone (choledochoduodenopancreatic zone) - between the anterior midline and the line connecting the navel with the right armpit and the perpendicular lowered to the midline from the Desjardins point

3.Zone (point) of Gubergrits - Skulsky is located in the zone (point) of the symmetrical zone of the Shofar - (body, tail of the pancreas)

Mayo-Robson symptom - soreness in the left hypochondrium (inflammation in the tail of

in

the area of ​projection of the pancreas on the anterior abdominal wall Kerte's symptom - with superficial palpation of the abdomen of a patient with AP, pain and tension of the abdominal muscles in the epigastrium, sometimes in the left hypochondrium or in the place of the pancreas projection on the abdominal wall.

Pain points and zones detected by palpation in patients with chronic pancreatitis:

АОВ —Shoffard's choledochopancreatic pain zone; СОВ —pain zone M. Gubergritz - Skulsky;

Д — Desjardins pain point;

Г — painful point of A. Gubergrits.

The projection of the pancreas on the abdominal wall.

МР — Mayo-Robson's pain point.

Areas of cutaneous hyperesthesia with involvement of the head (1), body (2) and tail (3) of the pancreas

Visceral pain (shaded) and the direction of pain irradiation in chronic pancreatitis (Mazatka Z., 1967):

A - through the epigastrium into the back (dorsally);

B - in the left hypochondrium and under the left scapula (in the form of a left-sided half-belt);

C - in the right hypochondrium and under the right scapula (in the form of a right-sided half-belt);

BC - girdle pain.